Friday, 28 September 2012

Pretend play and autism

A lightsaber in production @ Wikipedia
I'm leaving the heavy biochemistry of late behind in this post with a link to an interesting paper recently posted on Twitter by Prof. Graham Davey (Twitter: @GrahamCLDavey) reviewing the current evidence on the impact of pretend play on child development*.

To quote: "...existing evidence does not support strong causal claims about the unique importance of pretend play for development".

Whoa there... pretend play over just play might not be such a vital component to child development? Y'mean all those hours honing my Vader-like lightsaber skills with those stuck together toilet roll tubes were wasted?

On reading such a paper my mind almost immediately wanders back to autism and publications like this one from Christopher Jarrold** reviewing the pretend play research base in autism alongside quite a few hours learning about play - imaginative and/or pretend play - through schedules like the ADOS. Indeed, isn't a problem with imagination and, by inference, imaginative/pretend play supposed to be a key hallmark of an autism diagnosis separating autism from not-autism? That was one of the findings from the artificial intelligence boiling down ADI-R paper published recently. So logically, does this mean that an absence/limitation of pretend play in cases of autism might not necessarily have such dire consequences for future development?

OK, I don't want to get too carried away here on the basis of one review. Indeed even the lead author, Prof. Angeline Lillard in this media piece admits that whilst pretend play probably doesn't have the final say in aspects such as creativity and problem-solving, it might very well aid in skills like language and social development - both key points to diagnosing autism; indeed social affect rolled into one according to the DSM-V suggestion. She also notes the very fuzzy issue in linking how specifically pretend play contributes to child development independently and outside of all the other factors which combine in that process called growing up.

It does however make me wonder whether the rigidity with which psychology has seemingly applied the importance of pretend play both in the context of autism and more generally in child development has been 'overstated'. Indeed, if we go back to the pretend play -- perspective-taking link as described by articles like this one by Doris Bergen*** for example, which makes mention of Theory of Mind (ToM), it makes me also wonder whether one could also question the global importance of ToM for 'proper' development too?

Individual differences? Compensation strategies? Have I said too much? Should I perhaps also not mention the recent paper by Sachse and colleagues on executive dysfunction and (adult) autism****?


* Lillard AS. et al. The impact of pretend play on children's development: a review of the evidence. Psychological Bulletin. August 2012.

** Jarrold C. A review of research into pretend play in autism. Autism. 2003; 7: 379-390.

*** Bergen D. The role of pretend play in children's cognitive development. Early Childhood Research & Practice. 2002; 4.

**** Sachse M. et al. Executive and visuo-motor function in adolescents and adults with autism spectrum disorder. JADD. September 2012: PMID: 23011252

---------- Lillard AS, Lerner MD, Hopkins EJ, Dore RA, Smith ED, & Palmquist CM (2012). The Impact of Pretend Play on Children's Development: A Review of the Evidence. Psychological bulletin PMID: 22905949